Mangiardi Marilena, Alfano Guido
Neurology and Neurophysiology Department of M.G. Vannini Hospital Rome.
Acta Biomed. 2018 Oct 8;89(3):397-399. doi: 10.23750/abm.v89i3.6956.
Nocturnal frontal lobe epilepsy (NFLE) is a focal epilepsy with seizures arising mainly during sleep and characterized by complex motor behavior or sustained dystonic posturing. First described in 1981, it was considered a motor disorder of sleep and was indicated as nocturnal paroxysmal dystonia (NPD). The debated on epileptic origin of this condition was demonstrated in 1990 and the term NFLE was introduced. Since then it has been demonstrated that the heterogeneous aspects of morpheic seizures were responsive to antiepileptic drugs (AED's) with sodium blocking action mechanism, especially the carbamazepine (CBZ). Aim of Work and Methods: We report a clinical experience of NFLE patients associated with sleep disorders treated with Lacosamide, AED's with a novel mechanism of action. In vitro electrophysiology studies have shown that lacosamide selectively boosts the slow inactivation of the sodium-voltage-dependent channels, resulting in a stabilization of the hypersensitive neuronal membranes.
On the treated patients we observed a positive clinical response to lacosamide therapy without significant side effects. In particular, the effective clinical response to the pharmacological treatment was obtained at a dose of 200 mg/day.
夜间额叶癫痫（NFLE）是一种局灶性癫痫，发作主要发生在睡眠期间，其特征为复杂的运动行为或持续性肌张力障碍姿势。1981年首次被描述，当时被认为是一种睡眠运动障碍，并被称为夜间阵发性肌张力障碍（NPD）。1990年证实了对这种疾病癫痫起源的争论，并引入了NFLE这一术语。从那时起，已证明形态学发作的异质性方面对抗癫痫药物（AED）有反应，这些药物具有钠阻断作用机制，尤其是卡马西平（CBZ）。工作目的和方法：我们报告了用拉科酰胺治疗与睡眠障碍相关的NFLE患者的临床经验，拉科酰胺是一种具有新型作用机制的AED。体外电生理研究表明，拉科酰胺选择性地增强电压依赖性钠通道的缓慢失活，从而使超敏神经元膜稳定。
在接受治疗的患者中，我们观察到拉科酰胺治疗有积极的临床反应，且无明显副作用。特别是，在剂量为200毫克/天时获得了对药物治疗的有效临床反应。
